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Photo showing a shadow figure changing a Medicare Advantage Billboard to read "Medicare DisAdvantage" Michael T. Braden January 29, 2026 Medicare Advantage MEDICARE ADVANTAGE PLANS OFTEN HAVE HIGHER COSTS THAN YOU WERE TOLD BY AN AGENT When you turn 64-1/2, your mailbox usually begins to overflow with flyers, postcards, brochures, and other advertising/marketing materials for Medicare plans. Many of these flyers promise $0 Premiums, a cornucopia of extras, and a bundle of extra benefits that seem too good to be true. While Medicare Advantage plans can offer an alternative to Original Medicare, they often can seem too good to be true, and once you get a bill, you realize that you are not getting what you thought you signed up for. Understanding how these expenses are generated is the first step in protecting your savings in retirement. It is crucial that you take a deeper dive and look beyond the premium and understand the potential out-of-pocket expenses that can accumulate throughout the year. For those seeking predictable costs and peace of mind, Medicare Supplement plans often provide a more stable financial solution. THE TRUTH HIDDEN IN MEDICARE ADVANTAGE PLANS Surprise costs in Medicare Advantage plans generally arise because of how these plans are structured. Unlike Original Medicare, which is a fee-for-service program managed by the federal government, Medicare Advantage plans are managed care policies sold by private insurance companies. These carriers agree to manage your care in exchange for a flat fee from Medicare. To make a profit, they often implement strict cost-control measures. This means they limit which doctors you can see and require approval for specific procedures. If you step outside their rules, even accidentally, you become responsible for a significant portion of the bill. This structural difference is the primary reason beneficiaries often face unexpected expenses, unlike the comprehensive coverage offered by Medigap   plans. NOBODY TOLD YOU ABOUT OUT-OF-NETWORK COSTS One of the most significant financial shocks comes from receiving care outside of your plan’s network. Medicare Part C Plans ( Medicare Advantage ) typically operate as HMOs or PPOs, restricting you to a specific list of doctors and hospitals. In an HMO, you generally have no coverage for non-emergency out-of-network care, meaning you must pay 100% of the cost. Even with a PPO, seeing a provider outside the network results in significantly higher copayments or coinsurance. This contrasts sharply with Medicare Supplement plans, which allow you to see any doctor in the United States who accepts Medicare, ensuring you are never penalized for choosing the best provider for your health needs. THE REPROCUSSIONS FROM HAVING TO CHASE DOWN PRIOR AUTHORIZATIONS Another hidden hurdle is the requirement for prior authorization . Before you can receive specific tests, surgeries, or therapies, your doctor must ask the insurance plan for permission. If the plan denies the request or delays approval, you face a difficult choice: wait for the appeal process while your health suffers or pay for the treatment entirely out of pocket. These administrative barriers do not exist with Medicare Supplement plans, where medical necessity is determined by your doctor and Medicare, not an insurance company administrator looking to cut costs. CO-PAYMENTS AND REFERRALS CAN ADD UP QUICKLY While a zero-dollar premium sounds appealing, the “pay-as-you-go” model of Medicare Advantage can quickly become expensive. You will likely be charged a copayment for every single medical appointment. Specialist visits are particularly prone to high copays, often ranging from $40 to $50 or more per visit. If you have a chronic condition that requires seeing a cardiologist, endocrinologist, or other specialists frequently, these copays add up rapidly. In comparison, a Medicare Supplement plan can cover these “gaps,” leaving you with little to no cost at the time of service. UNFORESEEN CHANGES WITH PRESCRIPTION MEDICATIONS Prescription drug coverage is often bundled into Medicare Advantage plans, but this convenience can backfire. Plans can change their formularies and the list of covered drugs every single year. A medication that was in a low-cost tier one year might move to a higher tier the next, drastically increasing your copay. Furthermore, if your specific drug is removed from the formulary, you may have to pay the full retail price or go through a lengthy exception process. NOT REALLY UNDERSTANDING YOUR MOOP Marketing materials frequently highlight the Maximum Out-of-Pocket   (MOOP) limit as a safety net. However, this safety net is often set much higher than many beneficiaries realize. For 2026, the maximum out-of-pocket limit for in-network services can reach $9,250. This means you could potentially pay over nine thousand dollars in copays and coinsurance before the plan covers 100% of your costs. For many seniors, this amount is far beyond their means. Medicare Supplement plans typically result in far lower annual out-of-pocket expenses, providing proper financial protection. LIMITS AND STRUCTURE OF THE EXTRA ADDED BENEFITS The dental, vision, and hearing benefits touted by Medicare Advantage plans often come with strict limitations. The coverage is frequently capped at a low dollar amount, such as $1,000 or $1,500 per year, which does not cover major procedures like root canals, crowns, or high-quality hearing aids. Additionally, these benefits are often restricted to a tiny network of dentists and optometrists. You may find that your preferred dentist does not accept the plan, rendering the benefit useless unless you switch providers. URGENT CARE BILLING IS NOT THE HOSPITAL EMERGENCY ROOM Finally, billing confusion between emergency room and urgent care visits can lead to expensive surprises. If you visit an emergency room for a condition the plan later deems “non-emergent,” the plan may downgrade your coverage, leaving you with a higher bill. Conversely, if you go to an urgent care center that is out-of-network while traveling, you might not be covered at all. Medicare Supplement plans travel with you nationwide , providing consistent coverage whether you are at home or visiting grandchildren in another state. PEACE OF MIND IS PART OF FEELING HEALTHY AND PROTECTED Navigating the complexities of Medicare does not have to be a guessing game. While Medicare Advantage plans may initially appear attractive, the potential for surprise bills can disrupt your retirement budget. Medicare Supplement products offer a robust alternative, providing predictable costs, freedom of choice, and comprehensive coverage that lets you focus on your health rather than your wallet.

Michael T. Braden, November 7, 2025 MEDICARE SUPPLEMENTS Photo of Prescription Tablets and $100 Bills with the caption "What are the benefits of Medigap insurance?" When those new to Medicare first enroll in Medicare, they are mainly focused on the cost of their premiums, what their deductibles are, whether or not all of their favorite doctors and hospitals are in their network, and how in the world they are ever going to remember everything about Medicare! Medicare Supplement plans, also known as Medigap, are designed to fill the gaps left by Original Medicare . Still, for many people, the benefits of having a Medigap/Medicare Supplement Policy are sadly never made clear to them, especially if they self-enrolled or worked with a Medicare Agent/Broker who wasn't as thorough or detailed as they should have been. Many of the most important aspects of Medicare Supplement/Medigap plans are oftentimes hidden in the plan's fine print. These benefits do not just save you money; they can save you thousands during a serious medical event. Understanding these overlooked features helps you appreciate the true value of your policy and why a Medigap plan offers confidence and peace of mind, knowing you are well covered beyond basic healthcare. NO CO-PAYS OR CO-INSURANCE One of the most immediate benefits of a MEDIGAP or MEDICARE SUPPLEMENT Plan/Policy is the full coverage of your Medicare Part B charges. Under Original Medicare, you are responsible for 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment. There is no cap on this 20%, meaning if you have a $100,000 surgery, you could owe $20,000. Most Medigap plans cover this entire 20% cost for you. This means that after you meet your annual Part B deductible ($283 for 2026) , you can relax and rest assured that you will not be on the hook for unexpected Medical procedures or emergency health issues. ENHANCE PART A BENEFITS THAT EXCEED ORIGINAL MEDICARE Hospital stays can be costly, and Original Medicare has limits. Part A covers your hospital costs for the first 60 days of a benefit period after you pay a deductible. However, if your stay extends beyond that, you begin to pay a daily coinsurance amount that increases significantly over time. Medicare Supplement plans provide a crucial safety net here. They cover the Part A coinsurance for days 61-90 and your Lifetime Reserve Days for days 91-150. Even more importantly, once you have exhausted all your Medicare hospital benefits, Medigap plans provide coverage for an additional 365 days of inpatient hospital care during your lifetime. This extended coverage is a benefit we hope you never need, but it is invaluable if you do. Photograph of Braden Medicare Insurance's 2026 Medicare Supplement Plan Comparison Chart GREATER BENEFITS FOR SKILLED NURSING FACILITIES Recovering from a serious illness or injury often requires time in a Skilled Nursing Facility (SNF). Medicare Part A covers the first 20 days in full, but from day 21 through day 100, there is a daily coinsurance charge. For 2026, this daily cost is $217. That daily fee adds up quickly—over $6,500 for a month-long stay. Medigap plans protect your savings by covering the coinsurance amount in full. This allows you to focus on your rehabilitation and recovery rather than worrying about a mounting daily bill. COVERING PART B EXCESS CHARGES Some doctors and providers do not accept Medicare Assignment , meaning they do not agree to accept the Medicare-approved amount as full payment. By law, these providers can charge you up to 15% more than the Medicare-approved rate. These are called “excess charges.” If you have a Medicare Supplement Plan F or Plan G, the plan pays 100% of these excess charges for you. You can see any doctor who accepts Medicare, even if they do not accept assignment, and you will not see a bill for that extra 15%. This benefit significantly widens your access to specialists and top-tier medical centers. COVERAGE FOR BLOOD TRANSFUSIONS Original Medicare only pays for blood transfusions starting with the fourth pint of blood in a calendar year. You are financially responsible for the first three pints, which can be surprisingly expensive. Now, raise your hand if you knew that the cost for a Pint of Blood averages $200 - $300! I think most people are shocked the first time they see charges for Blood after Surgery or after a Hospital Stay. Thankfully, every Medicare Supplement/Medigap plan covers the first three pints of blood, making sure that you, the Medicare Beneficiary, are not stuck with a hefty bill. 20% CO-PAYS FOR MEDICAL EQUIPMENT (DME) Durable Medical Equipment (DME) includes items like wheelchairs, walkers, CPAP machines, and hospital beds. Under Original Medicare Part B, you typically pay 20% of the cost for this equipment. Because DME can be costly, that 20% share can be a burden. Your Medicare Supplement plan steps in to pay this coinsurance, making essential equipment affordable and accessible when you need it most to maintain your independence at home. CONSISTENT COSTS FOR YOUR BUDGET Perhaps the most “overlooked” benefit is not a specific medical service, but a financial one: predictability. With a Medigap plan, you know exactly what your costs will be. You pay your monthly premium, and in return, you have little to no out-of-pocket expenses for covered services. This predictability makes retirement budgeting much easier. You do not have to set aside a large “rainy day” fund for medical copays or surprise bills because your insurance is doing the heavy lifting for you. OVERSEAS EMERGENCY BENEFITS Medical emergencies often happen when we are least prepared. Whether it is a sudden need for emergency care while traveling abroad – which many Medigap plans cover up to a lifetime limit of $50,000 – or protection against unexpected “excess charges” from a specialist, these plans are designed to handle the surprises. By filling the financial gaps left by Original Medicare, a Supplement plan serves as a shield against catastrophic costs that could otherwise derail your retirement finances. COMPANIES MAY OFFER ADDITIONAL BENEFITS While the government standardizes the medical benefits of Medigap plans, private insurance carriers often compete for your business by offering extra perks. These can include “household discounts” if you and a spouse both enroll, or memberships to gym networks like SilverSneakers , Renew Active, and Silver & Fit, or Active & Fit . Some carriers also offer add-on packages for vision, dental, and hearing coverage, which are not covered by Original Medicare or standard Medigap plans. It is always worth asking what “extras” are available when you compare quotes.

Michael T. Braden December 11, 2025 MEDICARE 101 Many people are surprised to learn that Original Medicare does not include an annual cap on expenses, meaning deductibles, copays, and coinsurance can accumulate without limit. In contrast, Medicare Advantage plans are required to set an out-of-pocket maximum with limitations, and Medigap plans can significantly reduce your costs or provide a maximum limit on out-of-pocket expenses, depending on the plan you choose. In this article, we explain what the Medicare out-of-pocket maximum really means, how it works across different types of Medicare coverage, and how you can better insulate yourself from unexpected medical bills. Photo showing a Male's Hand pulling money out of his wallet to pay Medicare Maximum Out-Of-Pocket Amounts FAST FACTS FROM 2025 Original Medicare (Parts A and B) has no annual medicare Out-Of-Pocket Maximum Amount, so beneficiaries can theoretically face unlimited costs for deductibles, copays, and coinsurance. The two ways a Medicare beneficiary can limit the maximum annual out-of-pocket costs for Medicare bills are to add a Medicare supplement or replace their original Medicare with a Medicare Advantage plan. Medicare Advantage plans, aka Medicare Part C, must include out-of-pocket costs that cap your yearly spending on covered, in-network services. In 2025, the highest allowed limit was $9,350 for in-network services and $13,300 for out-of-network services. Many plans offer lower limits, but these limits can change annually and will increase with inflation. Medicare Supplement/Medigap plans may provide varying levels of coverage and out-of-pocket maximums; some plans, such as Plan G, offer very low maximums (limited to the Part B deductible, which is under $300), whereas others, such as Plans K and L, have higher limits due to partial coverage. All Medicare supplement plans provide greater coverage and lower out-of-pocket costs than Medicare Advantage plans. Out-of-pocket limits do not include monthly insurance premiums or services not covered by Medicare or your Medicare replacement plan. During initial conversations with clients, we are often asked if Medicare has a maximum out-of-pocket limit for covered health services.  While the topic should be relatively simple, I am amazed by the level of confusion and misinformation spread by professional insurance agents who are supposed to be knowledgeable about it. It’s important to note that monthly premiums for medical insurance, including drug coverage and Medicare Part B, are not included in maximum out-of-pocket cost limits. Monthly premiums are recurring costs that beneficiaries pay each month, regardless of their out-of-pocket spending. In this article, I will be covering the subject of maximum out-of-pocket limits for Original Medicare (Medicare Part A and Medicare Part B), along with private medical insurance options, including Medicare supplement insurance, Medicare Part D prescription drug coverage, and Medicare Advantage Plans. MOOP EXPENSES EXPLAINED When a person first enrolls in Medicare, they typically start with Medicare Part A  inpatient services and Medicare Part B , outpatient services.  You can enroll in Medicare Part A months or years before Part B. However, these are the two parts of Medicare required before deciding on a Medicare supplement or Medicare Advantage plan. Original Medicare does not have an annual maximum out-of-pocket limit.  It was never intended to be a stand-alone, full-coverage option for seniors. There is no cap on Medicare out-of-pocket spending in Original Medicare, meaning your Medicare out-of-pocket costs can theoretically be unlimited. Out-of-pocket costs or expenses include deductibles, copayments, and coinsurance. These medical expenses can add up quickly without a maximum limit. The only way to place a maximum out-of-pocket on your financial risk for covered health services is to either purchase a Medicare supplement Plan or a Medicare Advantage Plan. For those who qualify, Medicare beneficiaries can access savings programs through Medicare to help manage out-of-pocket costs, including premiums, deductibles, copayments, and prescription drug expenses. MEDICARE SUPPLEMENT MOOP MEDICARE-OUT-OF-POCKET) EXPENSES. Do Medicare Supplement Plans, which can be part of your medical insurance, have an annual out-of-pocket maximum? Some Medicare supplement plans have a hard annual out-of-pocket maximum, whereas others have a “soft” maximum. For example, the out-of-pocket maximum for Plan G is equal to the Medicare Part B deductible ($283 for 2026), a “hard” fixed maximum out of pocket.  The out-of-pocket maximum for high-deductible Medigap plans equals their annual deductible ($2,950 in 2026), again a hard limit. However, your out-of-pocket maximum for Plan N is the Part B deductible plus office/ emergency room copays.  We have no way of knowing how many office visits you may have in any given year, but we can assume a reasonable number. That is a soft annual out-of-pocket maximum. For 2026, the out-of-pocket maximum for Plan K is $8,000; for Plan L, it is $4,000 .   The out-of-pocket maximum applies only to medical services approved or accepted by Medicare and does not include any services or procedures not covered by these supplemental plans. Do Medicare supplement plans  have a maximum out-of-pocket?  Yes, most Medicare supplement plans (aka Medigap Plans, also known as Medicare supplement insurance) have a defined annual maximum out-of-pocket that limits the financial risk for the consumer.  In fact, among your Medicare choices, nothing comes close to the financial risk protection you can achieve with a Medicare supplement.  Unfortunately, we've heard from people and read that Medicare supplements do not have a maximum out-of-pocket limit.  Where does the confusion come from?    Believe it or not, it’s Medicare.    It’s from very poorly communicated benefits, directly from Medicare publications. 2026 MEDIGAP PLAN COMPARISON CHART Photo of the 2026 Braden Medicare Insurance Medicare Supplement Plan Comparison Chart The Braden Medicare 2026 Medicare Supplement Comparison Chart is the same table we used to find on the Medicare.gov website and in their publications, provided by private insurance companies. The benefit table lists 12 Medicare supplement plans.  Ten across, then asterisks on the F and G to indicate that those plans have a high-deductible option. Private insurance companies offer these Medicare supplement plans, and each may offer different plan options and coverage details.    COMPARING MEDICARE SUPPLEMENT PLANS In studying this Comparison Chart, you will quickly notice that both Plans K & L have this extra box titled “out-of-pocket limit”.  However, none of the other supplement plans show a row with the same title, and none include lifetime reserve days. Because of this communication failure, it’s easy to assume that those Medigap plans lack an annual out-of-pocket maximum.  Right?  That is undoubtedly what most people think, including many insurance agents who should know better. You know what they say about assumptions.  Of course. But the blame here lies directly with Medicare for a poorly designed presentation, and it’s the government's fault.  The government doesn’t typically have ears for consumer feedback. I can also tell you from years of experience that many of the government publications are not written by industry experts. The federal government sets the rules and benefit tables for Medicare plans offered by private insurers. , including maximum out-of-pocket costs and other standardized protections. Let’s look at why these two Medigap plans, K and L, show a maximum out-of-pocket designation, where the other plans don’t need one. Who Needs A Maximum Limit When the Plan Pays 100% You might notice that, when you look closely at the table, most Medicare supplement Plans show 100% coverage for the significant benefits. For example, Medicare Part B coinsurance or copayment.  That is the 20% that Medicare Part B does not cover. You have 100% coverage.  Everything is paid for until you reach Plans K and L. Medigap Plan K has only 50% coverage.  Medigap Plan L has only 75% coverage.  These coinsurance and copayment amounts apply to a wide range of medical expenses and medical services , including doctor visits, outpatient care, durable medical equipment, and covered drugs. Look at Part A hospital coinsurance.  Without a supplement, you have 60 days of coverage before you begin paying a daily copay.  That copay is covered 100% by a Medicare supplement plan, except for Plans K & L. Plan K covers 50%.  Plan L covers 75%.  Hospital costs, such as room and board, medications administered during your stay, and other inpatient services, are included in these expenses. Skilled Nursing.  Medicare Part A covers 100% of the first 20 days, with the consumer paying a daily copayment for days 21 through 100, with a total of no more than $17,360. That’s the maximum for 2026.  Skilled nursing facility costs , including daily care and rehabilitation services, are subject to these copays depending on your coverage. If you have Medicare Supplement Plan A or Plan B, you will pay any amount not covered by Medicare, including skilled nursing facility costs. This means that if you spend 100 days in a skilled nursing facility, you will pay up to $17,360.   If you have any other supplements except supplement plans K and L, you have 100% coverage.  100 days of skilled nursing care cost you nothing out-of-pocket. Zero. ($0). Plan K & L, The Only Partial Coverage Plans Medicare Supplement Plans K & L have a maximum out-of-pocket cost because they provide only partial coverage for primary services.  Consumers have substantial financial exposure to medical bills because they do not have 100% coverage for primary services, where catastrophic coverage could help mitigate that risk.  Without a set maximum out-of-pocket limit for those two plans, consumers would face unlimited financial exposure, which could result in a financial catastrophe for some people. Think of the annual maximum out-of-pocket costs as only referencing the benefits that are covered at either 50% or 75% by these two plans. Medicare Is Not Long-Term Care First, Medicare is not Long-term Care.   Long-term care needs are not even considered on this benefit table. For example, your Skilled Nursing Care benefits end at 100 days. At 101 days of Skilled Nursing, you have no Medicare benefits and no Medicare supplement benefits. It doesn’t matter whether these supplemental plans offer zero coverage for Skilled nursing (Plans A and B), 100% coverage (Plans C, G, and N), or 50%-75% coverage (Plans K and L). On day 101, your Medicare coverage is depleted. In addition, after you use your initial 90 days of inpatient hospital care, Medicare provides up to 60 additional ‘lifetime reserve days’ that can be used over your lifetime for extra hospital coverage. Once these are used, you must pay all costs out of pocket. Medicare coverage is structured around ‘benefit periods’: a benefit period begins the day you are admitted as an inpatient to a hospital or skilled nursing facility and ends after you have been out for 60 consecutive days. Each benefit period resets the deductible and coinsurance requirements, and multiple benefit periods can occur within a year, which may increase your out-of-pocket costs for inpatient care. A new benefit period begins after you have been out of the hospital or a skilled nursing facility for 60 days, and each new benefit period resets certain costs and coverage terms. You are on your own unless you have Long-Term Care Insurance. That is where your Long-Term Care insurance policy will begin. Does 100% Mean Everything? Second, and this is key, the maximum out-of-pocket cost limit applies only to what the Medicare supplement covers . Only costs for covered services count toward the out-of-pocket maximum; expenses for any covered service under the supplement plan, including those that Medicare covers, are included, whereas non-covered services are not. For example, the maximum out-of-pocket cost for Plan K in 2026 is $8,000.  However, that $8,000 applies only to the portion of the claim the supplement plan covers, excluding the annual deductible.  It does not cover the Part B deductible. That’s an additional expense not included in the maximum out-of-pocket.  It doesn’t cover Excess Charges.  If you have Excess Charges, they are in addition to the maximum out-of-pocket amount. Now let’s apply that information to Medicare Supplement Plans A and B.  For Medicare services covered by Plan A or Plan B, the plan covers 100% of the Medicare bill not paidby Original Medicare.  The maximum out-of-pocket cost only references the portion of Medicare services covered by the supplement.  There is no maximum annual out-of-pocket cost listed because the benefits they cover are 100%.   There is simply no supplemental insurance for Skilled Nursing. That means you have a maximum out-of-pocket of zero for the benefits it covers.  It just doesn’t cover as much as the other plans. There are inconvenient holes in the coverage. Does that make sense? Is There a Maximum Out-of-Pocket for Medicare Plan G? The maximum out-of-pocket for Plan G is the Medicare Part B deductible($283 for 2026). Medicare Supplement Plan G covers all inpatient and outpatient Medicare expenses not paid for by Medicare. Coverage is based on the Medicare-approved amount for each service, meaning Plan G pays costs that are Medicare-approved after you meet your deductible. Medicare covers hospital stays, doctor visits, and other health services, while Plan G fills in the gaps for expenses not fully covered by Medicare. Your only expense is the annual Part B deductible. There is also no annual or lifetime cap on the benefits you receive. Does Plan G Have a Deductible? No, regular Plan G does not have a deductible.  However, you must pay the 2026 Medicare Part B deductible of $283, unless you have a plan through a preferred provider organization that includes prescription drug coverage.  In addition, the b monthly premium is a separate, recurring cost for outpatient coverage and is not included in the out-of-pocket maximum.  The high-deductible version of Plan G has a $2,950 deductible for 2026.  That is also its maximum out-of-pocket. We must exclude Foreign Travel because Medicare does not cover emergency healthcare abroad, as stipulated in the Inflation Reduction Act.   That is simply an extra benefit provided by the supplement. Medicare Supplement Plan G covers 100% of all Medicare services. The only inpatient or outpatient Medicare service it does not cover is the annual Medicare Part B deductible.  That is $283 for 2026.    That’s it.  If you have a Medicare Supplement Plan G, your maximum out-of-pocket financial risk for 2026 is $283, which does not include prescription drug coverage. If you were to list a maximum out-of-pocket, the way this table is designed, it would be zero.  However, in real life, your maximum out-of-pocket will be the Medicare Part B deductible.  This is substantially lower than your financial exposure under Medicare Supplement Plans K and L.  In fact, it is the lowest maximum out-of-pocket financial risk a consumer can choose with Medicare. Considering real-life conditions rather than the limits of this table, let us examine the maximum out-of-pocket for other popular Medicare supplements, including potential drug costs. Medigap Plan N Out-of-Pocket Maximum When a Medicare supplement does not cover the Part B Excess Charges, like Medigap Plan N  and Medigap Plan D , for example, we presume the consumer will avoid excess charges. It’s very easy to do. However, beneficiaries should be aware that they will still need to pay out of pocket for copays and deductibles. Does Medicare Supplement Plan N Have a Deductible? No, Plan N does not have a deductible.  However, you will have to pay the annual Medicare Part B deductible, which is $283 for 2026. The monthly premium is a separate, recurring cost that is not included in your out-of-pocket maximum. ARE THERE CO-PAYS WITH PLAN N? Yes.  There is a $20 copay for office visits that involve diagnosis or evaluation.  There is a $50 copay for emergency room visits that do not result in a hospital admission.  These copays are part of the plan’s cost-sharing structure, which determines how much you pay out-of-pocket for covered services. Urgent Care and Telehealth visits can be billed as an office visit.    There is no copay for physical therapy or chemotherapy office visits. HOW DO PART B EXCESS CHARGES WORK IF YOU CHOOSE PLAN N? No.  Only Plan G and Plan F will pay Part B excess charges.  However, excess charges can be avoided by using Medicare’s online physician lookup tool. When you receive medical services, Medicare pays its approved portion of the costs first, and you are responsible for the remaining expenses, such as the Part B deductible and any applicable copays. With the presumption that excess charges will be avoided, the Medicare Supplement Plan N maximum out-of-pocket will be the amount of the Medicare Part B deductible plus any of the copays you pay for office visits.  There is a maximum of $20 for an office visit and $50 for a hospital emergency room visit. For a detailed comparison of these costs and coverage options, see Medicare Supplement Plan N vs Plan G . You may not have foreknowledge of the exact number of office visits you will have in a year, but for all practical purposes, that cost, including Part D cost sharing, will likely be less than the cost of the Part B deductible. In case you were not aware, not all office visits qualify for the $20 copay.  For details, please see my video on Best Medicare Supplement Plans linked below and above my left shoulder. The maximum out-of-pocket limit for a Medicare supplement Plan N is among the lowest available in Medicare.    For all practical purposes, it will be a number less than twice the Medicare Part B deductible and certainly much, much lower than Medicare supplement Plans K and L. HIGH DEDUCTIBLE MEDICARE SUPPLEMENT PLANS What about the high-deductible Medicare supplements ?  That’s easy.  The maximum out-of-pocket amount equals the deductible.  The deductible is $2,950 for 2026.  It increases each year with the Consumer Price Index (U), rounded to the nearest $10. That $2,870 deductible is much lower than the maximum out-of-pocket for Medicare supplement Plans K and L, which are $8,000 and $4,000, respectively (2026). High-deductible plans have lower out-of-pocket spending limits than some other plans, including those involving out-of-network providers, and they may offer catastrophic coverage, making them an attractive option for those seeking to minimize annual costs. With this understanding of the benefit table design, often dictated by the federal government, you should find it easy to define the maximum out-of-pocket limits for each supplemental plan.

Michael T. Braden, November 29, 2025 MEDICARE SUPPLEMENTS MEDIGAP PLANS F, G, & N ARE FAR AND AWAY THE BEST MEDICARE SUPPLEMENT PLANS IN AMERICA Medicare Supplement Plans F, G, and N are the three most popular Medigap Plans in the United States. Plan F has long been the Cadillac of Medigap Plans, but is now available only to those who turned 65 before January 1, 2020. Even though they have higher Out-Of-Pocket costs, Plan G and Plan N are more cost-effective than Plan F. Plans F, G, and N have been the most popular Medicare Supplement/Medigap plans for the past five years, and that is unlikely to change over the next 10 years. Many of my clients have begun paying closer attention to High-Deductible Plan G and High-Deductible Plan F. These plans are viewed more favorably by high-net-worth individuals. Photo Of Braden Medicare Insurance's Colorful 2026 Medicare Supplement Comparison Chart WHICH OF THE THREE PLANS IS THE BEST OPTION FOR YOU? The most comprehensive plan currently available is Medigap Plan F. It covers all Medicare gaps. The next most comprehensive plan is Plan G, which covers nearly as much, with the Part B deductible being the only difference. Finally, Plan N is likely the third most popular plan because it operates similarly to Plan G, except that you pay copays for doctor and ER visits and for your Medicare Part B coverage. Let’s first look at how Medigap plans are standardized, then discuss the features and benefits of each plan type: F, G, and N. WHAT DOES IT MEAN WHEN WE SAY THAT ALL MEDIGAP PLANS ARE STANDARDIZED There are currently 10 standard Medigap plans available in most states. (Massachusetts, Minnesota, and Wisconsin have their own plan standards.) However, for consumers, this means that Plan A offered by Company X in Anaheim is identical to Plan A offered by Company Y in Boise. While premiums may differ, benefits and coverage are the same. Private insurance companies offer Medigap plans, but they are not required to offer all 10 plans. However, any company that provides Medigap coverage must offer Plan A. Also, if it offers more than one plan, it must offer either Medigap Plan C or Plan F in addition to any other plans it provides. Plan F has been the most popular Medicare Supplement/Medigap Plan in the history of Medicare. Recent trends show that Plan N has seen the largest increase in New Policies since 2020, with Plan G close behind. Inflation over the past four years has made Medicare beneficiaries more discerning and deliberate when choosing the best Medicare Supplement plan for themselves and their families. WHAT YOU NEED TO KNOW ABOUT EACH PLAN MEDICARE SUPPLEMENT PLAN F COVERAGE Medicare Supplement Plan F is the best Medicare Plan for individuals who desire to have the best, comprehensive Medicare Plan available. Your Plan F Premium covers everything from the beginning. Plan F covers both your Part A and Part B deductibles, so you pay nothing before your Medicare benefits are triggered. Plan F makes particularly good common sense if a beneficiary has severe or chronic conditions. If you’re already enrolled in Plan F or were eligible for Medicare before 2020, you still have access to Plan F. You are grandfathered in. Personally, I do not think the premium difference is worth the choice between Plan F and Plan G. However, for our parents who have always had Plan F and are in their 80s or 90s, I think staying with Plan F is important. That is the plan they have always known, and it is not worth disrupting the Status Quo. HERE IS WHAT IS COVERED UNDER MEDICARE SUPPLEMENT PLAN G Medicare Supplement Plan G and Medigap Plan G are the same . Plan G is currently outselling most other Medigap plans because it offers the same broad coverage as Plan F except for the Part B deductible, which is $283 in 2026. The only difference when you compare Medicare Supplement Plan F and Plan G is the deductible. Otherwise, they function just the same. One crucial feature that Medicare Supplement Plans F and G have over all the other Medigap plans is that these two popular plans are the only Medicare Supplement Plans that offer coverage for Part B excess charges—and that’s important if you want maximum flexibility in choosing your healthcare provider. When you see a provider that doesn’t participate with Medicare, they can charge up to 15% more than the standard Medicare rate for your services. You will pay this money out of pocket unless you have a Medigap Plan F or Plan G. It’s something to consider if provider choice is essential to you. There are no plans to phase out Plan G, which is another good point to keep in mind. When we help beneficiaries explore Medigap plans, we run through Medicare Plan G pros and cons and compare it to other plans, such as Plan N. WHAT IS COVERED UNDER MEDICARE SUPPLEMENT PLAN N This is another fast-selling plan because it offers a good balance between protection against catastrophic out-of-pocket expenses and affordable premiums. Under Medigap Plan N , you have all the same coverage as Plan F except: No coverage for Part B deductible No coverage for Part B excess charges You may have a copay of up to $20 for certain doctor visits and $50 for hospital visits that don’t result in admission. This is one of the newer plans rolled out in 2010. It’s a good fit for individuals who are comfortable with some cost-sharing in exchange for lower premiums. It’s also not going anywhere, unlike Plan F. WHAT SHOULD YOU LOOK FOR WHEN COMPARING MEDIGAP PLAN F, vs PLAN G, vs PLAN N Be sure to consider the type of coverage you think you’ll want over the long term. Here’s why: In most cases, you do not have a guaranteed right to switch Medigap policies once you’re past your Initial Enrollment Period. Unless exceptional circumstances apply, such as a move out of your policy service area, you do not have a guaranteed right to switch. After your one-time Medigap Open Enrollment Period expires, you’ll be subject to medical underwriting once you apply for a new plan. That means the insurance company can refuse coverage or charge higher premiums for your plan. Some states, such as Nevada, Idaho, Illinois, Oregon, and California, have Medicare Supplement Birthday Rules that are more friendly to Medicare Beneficiaries by offering Guaranteed Issue of a new Medigap Policy as long as you apply during the correct enrollment period each year. For most people, this will either be their Birthday or the Anniversary Date of their current Medigap policy. In these states, you can change Medigap plans without medical underwriting or a premium penalty—but only for plans with the same or lower benefits than your existing plan. WRAPPING THINGS UP Medicare Supplement plans such as Plan F, G, and N are designed to help cover the gaps in Medicare and pick up those costs for you. Plan F is no longer available to new beneficiaries, but it is the most comprehensive Supplement plan. Plan G and Plan N do not cover the Part B deductible, and Plan N has more out-of-pocket costs, but they can be more cost-effective than Plan F. Photo of Michael Braden's Business Card. Braden Medicare Insurance is a Licensed, Independent Medicare Broker and a CMIP (Certified Medicare Insurance Planner). We are based in Chandler, AZ, and are also licensed in California, Colorado, Florida, Indiana, Iowa, Michigan, Nevada, New Mexico, Ohio, Texas, and Wisconsin. If you have any questions, would like a second opinion, or have a question about Medicare, please feel free to reach out to us anytime. We will never charge a penny for our time, knowledge, or expertise. Email us @ mike@bradenmedicare.com , call or text us @ (480) 225-1393, or visit us on our website at www.bradenmedicare.com anytime, 25/7.

Michael T. Braden January 1, 2026 MEDICARE 101 MEDICARE JUST RELEASED THEIR PREMIUM COSTS FOR 2026 Navigating the world of Medicare can sometimes feel overwhelming, especially when the costs change each year. Understanding these adjustments is essential for budgeting and The official 2026 numbers have been released by the Centers for Medicare & Medicaid Services (CMS). We are here to walk you through these new costs, explain what they mean for you, and show you how to manage them effectively. COSTS COVERED UNDER MEDICARE A Medicare Couple Reviewing Costs and Making their Budgets For the 2026 Medicare Plan Year When we talk about “Medicare costs,” we are generally referring to a few different types of payments you might make: Premium: A fixed amount you pay each month for your coverage (like Medicare Part B). Deductible: The amount you must pay for healthcare services before Medicare begins to pay its share. Coinsurance: The percentage of the cost you pay for a service after you have met your deductible. Copayment: A fixed dollar amount you pay for a service (familiar with Medicare Advantage and Part D plans). MEDICARE PART A Medicare Part A , which covers inpatient hospital stays, skilled nursing facility care, and hospice care, is often referred to as “premium-free.” Most people do not pay a monthly premium for Part A. This is true if you or your spouse paid Medicare taxes for at least 10 years (or 40 quarters) while working. However, Part A does have costs related to its services: Inpatient Hospital Deductible: In 2026, the Part A deductible for each hospital benefit period is $1,736. This is an increase of $60 from $1,676 in 2025. You must pay this amount when admitted to the hospital. Hospital Coinsurance: After your deductible is met, you pay $0 for the first 60 days. Days 61-90: $434 per day Lifetime Reserve Days (Days 91+): $868 per day Skilled Nursing Facility Coinsurance: For days 21-100 of care, your cost will be $217 per day. MEDICARE PART B Medicare Part B covers doctor visits, outpatient services, preventive care, and durable medical equipment. These are the costs that most beneficiaries will see in their monthly budget. Standard Monthly Premium: The 2026 standard Part B premium is $202.90 per month. This is a significant increase from the $185 monthly premium in 2025. Annual Deductible: The 2026 yearly Part B deductible increased from $257 to $283. This is the amount you must pay for outpatient services before Part B begins to pay. Coinsurance: After you meet the $283 deductible, you are typically responsible for 20% of the Medicare-approved amount for most services. This 20% has no annual limit. 2026 MEDICARE SUPPLEMENT PLANS Those potential Part A and Part B costs—such as the $1,736 hospital deductible and the unlimited 20% Part B coinsurance—are why many people choose a Medicare Supplement plan, also known as a Medigap plan. Private insurance companies sell Medigap plans and are explicitly designed to “fill in the gaps” left by Original Medicare. You pay a separate monthly premium for your Medigap plan. In return, the plan covers many or all of your out-of-pocket costs. For example, popular plans like Medigap Plan G  will pay for your Part A deductible, your Part A coinsurance, and—most importantly—your 20% Part B coinsurance. By paying a predictable monthly premium for a Medigap plan, you protect yourself from large, unexpected medical bills. This makes budgeting for healthcare much simpler and provides invaluable peace of mind. 2026 MEDICARE ADVANTAGE & MEDICARE PART D It is essential to know about all your options: Medicare Part C (Medicare Advantage): These plans are an alternative to Original Medicare, offered by private companies. You must still pay your Part B premium. These plans bundle Part A, Part B, and often Part D (drug coverage) into a single plan. They have their own cost structures with copayments and networks. For 2026, the average monthly premium for these plans is projected to decrease slightly. The maximum out-of-pocket limit for Part C plans in 2026 will be $9,250. Medicare Part D (Prescription Drug Coverage): This is your standalone coverage for prescription drugs. Private insurers also sell these plans, and their costs vary widely. DID YOU KNOW YOUR INCOME CAN AFFECT YOUR PREMIUMS Your monthly Medicare premiums may be higher based on your income. This is called the Income-Related Monthly Adjustment Amount   (IRMAA). This surcharge applies to individuals and couples with higher earnings. For 2026, IRMAA is based on your Modified Adjusted Gross Income (MAGI) from your 2024 tax return. The adjustment begins for individuals with a 2024 MAGI exceeding $109,000 and for couples filing jointly with a 2024 MAGI exceeding $218,000. If your income falls into this range, the Social Security Administration will add a surcharge to both your Part B and Part D premiums. For example, an individual with a 2024 MAGI between $109,001 and $137,000 will pay an extra $81.20 per month for Part B, for a total monthly premium of $284.10. 2026 MEDICARE IRMAA BRACKETS Picture Of Medicare's IRMAA Brackets For High-Wage Earners in 2026. MEDICARE SEEMS TO RAISE ITS RATES EACH YEAR. WHY? Most people wonder why Medicare raises their costs every year. The federal government sets the premiums and deductibles for Medicare Part A and Part B . They are adjusted annually based on several factors, including: Overall Healthcare Costs: The rising prices of medical services, treatments, and technologies. Program Spending: The adjustments must cover the projected costs for all Medicare beneficiaries in the coming year. Drug Costs: CMS has noted that rising spending on physician-administered drugs is a key driver of Part B premium increases. TIPS TO REDUCE YOUR MEDICARE-RELATED OUT-OF-POCKET COSTS HERE IS WHAT EVERY MEDICARE BENEFICIARY SHOULD DO EVERY YEAR Review Your Coverage Annually: The Annual Enrollment Period (AEP) each fall is the perfect time to review your Part D or Medicare Advantage plan to ensure it still meets your needs and budget. Enroll in a Medigap Plan: If you have Original Medicare, the most effective way to manage unpredictable costs is to enroll in a Medicare Supplement (Medigap) plan. By covering the Part A deductible and the 20% Part B coinsurance, a Medigap plan provides a powerful buffer against rising healthcare expenses. Check for Assistance Programs: You may be eligible for a Medicare Savings Program  (MSP) or Extra Help, which can assist with paying premiums, deductibles, and prescription drug costs. WRAPPING THINGS UP We hope you found this Article detailing the new Medicare costs for 2026 helpful and informative. If you ever have any Medicare questions and are unsure who to contact, please reach out to us anytime. You can email me at mike@bradenmedicare.com , use the Contact Us page on our website at www.bradenmedicare.com, or call or text me at (480) 225-1393 at your convenience.

Michael T. Braden January 7, 2026 Medicare Supplements __________________________________________________________________________________ Braden Medicare Poster showing a Green Arrow for Plan F, a Blue Arrow for Plan G, and a Gold Arrow for Plan N. As we begin 2026, I thought it was time to take a closer look at Medicare Supplement Insurance and update everyone on the current state of Medicare Supplement and Medigap plans in America. A little over 50% of Medicare Beneficiaries have Medicare Supplement/Medigap Insurance, often called Medigap Insurance. These policies are designed to work alongside your Original Medicare benefits, covering the financial gaps that Original Medicare leaves behind. Historically, beneficiaries had a wide array of lettered plans to choose from, each offering a different level of standardized coverage. This standardization ensures that a Plan G from one carrier offers the same benefits as a Plan G from another. Over time, federal regulations have adjusted these options to modernize the system and manage costs. The most significant changes have concerned which plans can cover the Medicare Part B deductible. This shift has fundamentally altered the landscape, moving the spotlight away from the once-dominant Plan F and illuminating the modern value of Plan G . REMEMBER WHEN PLAN F WAS THE BEST AND MOST POPULAR MEDICARE SUPPLEMENT PLAN? For decades, Medigap Plan F was the dominant option in Medicare supplements. Its popularity was straightforward: it offered “first-dollar” coverage. This means that from the moment you sought medical care, Plan F paid for everything that Medicare approved but did not fully cover. You had zero out-of-pocket costs for deductibles, copayments, or coinsurance. Beneficiaries loved the peace of mind that came with Plan F. You paid your monthly premium, and in return, you never had to pull out your wallet at the doctor’s office. This convenience made it the default choice for millions of older adults who sought the most comprehensive protection available, regardless of the monthly cost. THE IMPACT AND FALLOUT OF MACRA IN 2015 The turning point for Plan F was the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This federal law aimed to reduce healthcare overutilization by ensuring that beneficiaries have some “skin in the game.” The logic was that if patients had to pay a small deductible, they might be more mindful of their medical usage. As a result, as of January 1, 2020, Medigap plans that cover the Part B deductible were no longer allowed to be sold to newly eligible Medicare beneficiaries. This effectively closed the door on Plan F for anyone turning 65 or becoming eligible for Medicare on or after that date. While those who were already eligible before 2020 can still buy or keep Plan F, the pool of potential new members has vanished. HOW MEDICARE SUPPLEMENT PLAN G OVERTOOK PLAN F AS THE BEST AND MOST POPULAR MEDICARE SUPPLEMENT PLAN IN THE U.S. Once Plan F was no longer available to new Medicare Beneficiaries who turned 65 after January 1, 20200, Medicare Supplement Plan G naturally rose to take its place. Plan G is virtually identical to Plan F in terms of coverage, with one solitary difference: it does not cover the Part B deductible. Plan F automatically paid the Annual Part B Deductible for individuals. This was convenient, but it is not worth the cost. And, the government, and Medicare is part of the government after all, wanted the same rules for everyone. This led to the discontinuation of Plan F and Plan C for new Medicare beneficiaries effective January 1, 2020. For new beneficiaries, Plan G offers the most comprehensive coverage currently available. It covers your Part A deductible, Part A and B coinsurance, skilled nursing facility coinsurance, and even Part B excess charges. Because it mirrors the rich benefits of Plan F so closely, it has become the new “gold standard” for those seeking maximum protection against unexpected medical bills. RECENT TRENDS WE HAVE SEEN WITH MEDIGAP PREMIUMS The closure of Plan F to new members has created a “shrinking risk pool.” In insurance, stability comes from a continuous influx of new, younger, and generally healthier members to offset the claims of older, sicker members. Since no new Plan F policyholders are joining, the existing group of policyholders is aging together. As this group ages, it naturally requires more medical care, resulting in higher claims. To cover these costs, insurance carriers must raise premiums. Consequently, Plan F rates are increasing more rapidly than Plan G rates. Plan G, by contrast, is open to all new 65-year-olds, thereby keeping its risk pool diverse and its premiums more stable. A QUICK GLANCE AT THE DIFFERENCES BETWEEN PLAN G AND PLAN F When you compare the two side by side, the similarities are striking. Both plans cover: Medicare Part A coinsurance and hospital costs Medicare Part B coinsurance or copayment Blood (first 3 pints) Part A hospice care coinsurance or copayment. Skilled nursing facility  care coinsurance Part A deductible Part B excess charges Foreign travel emergency (up to plan limits) The only difference is the Part B deductible. In 2026, the standard Part B deductible is $283. With Plan F, this is paid for you. With Plan G, you pay this amount out of pocket annually. Often, the annual premium savings you get with Plan G far exceed this small deductible amount, making Plan G the more mathematically sound choice. THE ASTOUNDING GROWTH OF MEDIGAP PLAN N While Plan G captures the majority of the market, Plan N has emerged as a strong contender for the budget-conscious consumer. Plan N offers lower premiums than Plan G in exchange for a cost-sharing structure. With Plan N, you pay the Part B deductible (just like Plan G), but you also have copayments of up to $20 for some doctor’s office visits and up to $50 for emergency room visits that do not result in admission. Why do we say up to $20 for an office visit? That is easy, there are about 12 different codes the doctor's office can use for an office visit , each code has a different dollar amount, from $0 on up to a maximum of $20. Each doctor is different, and there are no strict rules; if someone is greedy, they will charge the extra fees. There are no strict rules; if someone is greedy, they will charge the extra fees. There are no strict rules; if someone is greedy, they will charge the extra fees. There are no strict rules; if someone is greedy, they will charge the extra fee of $20 . Many doctors charge $0. Additionally, Plan N does not cover Part B excess charges. For healthy seniors who do not visit the doctor frequently, Plan N can provide significant monthly savings while still offering robust catastrophic protection. ARE THE HIGH DEDUCTIBLE PLAN G (HDG) AND PLAN F (HDF) WORTH LOOKING AT? For those looking to minimize monthly expenses, both Plan F and Plan G offer high-deductible options in many states. These plans require you to pay a substantial deductible ($2,950.00 in 2026) before the plan begins to pay anything. These options are best suited for beneficiaries with significant savings to cover the deductible in the event of a major health event, but who prefer a very low monthly premium. If you are generally healthy and live in a state where these plans are available, they can be a strategic way to self-insure for small costs while retaining a safety net for large hospital bills. LOOKING FORWARD AND TRYING TO PROJECT WHAT WILL HAPPEN TO PLAN F IN THE FUTURE? The future of Plan F is one of gradual decline. It will not disappear overnight, and those who have it can keep it. However, the premiums will likely continue to rise disproportionately compared to other plans. We are already seeing significant rate increases for Plan F in many states. As the price gap between Plan F and Plan G widens, more members will likely leave Plan F, further accelerating the rate increases for those who remain. It is a cycle that makes Plan F less attractive with each passing year. THE BEST WAY TO CHOOSE BETWEEN PLANS F, G, AND N. Choosing the right plan depends on your eligibility, budget, and risk tolerance. Choose Plan F only if you were eligible for Medicare before 2020 and the premium is comparable to Plan G plus the Part B deductible (which is rare). Choose Plan G if you want the most comprehensive coverage available to new enrollees and want to eliminate almost all unpredictable medical costs. Choose Plan N if you are willing to pay small copays in exchange for a lower monthly premium. Ultimately, the best way to determine the right fit is to compare real-time quotes for each plan. Then involve your Family Members in the decision and determine what makes the most sense for you as an individual. Personally, I think Plan G makes the most sense over the long haul. Plan N might be good for the next 10 years. Still, as we age, we see more doctors, more often, so Plan G usually makes the most sense later, It is important to remember that if you have a Plan N, you can apply for a Plan G any day of the year; however, if you do not live in a state that has adopted a Medicare Supplement Birthday rule, you will have to pass underwriting for any new policy. And many times, people are denied for a variety of reasons, including their medications, Their Health Risks, and their past, current, and future health history. WRAPPING THINGS UP Over the years, my experience is that couples always want the best coverage for their spouse and are often willing to have a lower policy for themselves, yet 99% of couples end up with the same plan for both. It makes sense, and it is easier for everyone involved. Plan N can save you money, and if the premium increases that Plan G has had the past few years, Plan N could become the best value for everyone, but I do not think we are there yet. Plan N is a great option, and Plan G is more comprehensive. People choose insurance to have a partner who assumes the risk of their healthcare in exchange for a monthly premium, and Plan G offers lower risk. At Braden Medicare Insurance, we are happy to speak with anyone who has questions about Medicare, plan options, or how to compare them in the most straightforward, most effective way. Please email mike@bradenmedicare.com anytime, call us at (480) 225-1393, or complete the contact form on our website, www.bradenmedicare.com .

Michael T. Braden January 4, 2026 Medicare Supplement Plans Braden Medicare Insurance Poster Showing An Image Of 3 Colorful Thought Boxes, with the caption "Did You Know This About Medicare Supplement Plans? Medicare is excellent healthcare coverage. Medicare is the National Health Insurance Program for all Americans 65 and older and for those who have been determined to have a full-time disability. For many Medicare beneficiaries, this realization comes as a shock when the first medical bill arrives. This is where Medicare Supplement  insurance comes in. Medicare Supplemental policies, also referred to as Medigap Plans, are designed to fill gaps left by Original Medicare (Medicare Part A & Medicare Part B). Medigap steps in to fill the financial voids left by Original Medicare. While you may know these plans help cover copayments, coinsurance, and deductibles, several lesser-known features make this coverage even more valuable. Understanding these nuances can help you make a more informed decision about your healthcare future. Here are five surprising facts about Medigap that might change how you view your coverage options. MEDIGAP PLANS ARE STANDARDIZED, SO THE COVERAGE IS THE SAME IN ALL 50 STATES, BUT THE PRICES VARY FROM STATE TO STATE One of the most comforting aspects of Medigap is that the federal government standardizes the plans. This means that a Plan G from one insurance carrier must offer the same benefits as a Plan G from another. If you purchase a Plan G , you are entitled to the same coverage for skilled nursing facility coinsurance, Part A deductibles, and Part B excess charges , regardless of which company logo is on your card. However, the premiums for these identical plans can differ widely. Insurance companies set their own rates based on various factors, including their pricing method (community-rated, issue-age-rated, or attained-age-rated), administrative costs, and the level of risk they manage. It is not uncommon to find two different companies charging vastly different monthly premiums for the same set of benefits. This reality underscores the importance of comparing rates from multiple carriers to ensure you are not overpaying for your coverage. IF YOU MEET THE THRESHOLD, YOU CAN STILL ENROLL IN "GRANDFATHERED MEDICARE PLANS" IF YOU QUALIFY If you have been researching Medicare for a while, you may have heard of Plan F or Plan C. These plans were once highly popular because they covered the Medicare Part B deductible, meaning the policyholder had virtually no out-of-pocket costs for doctor visits. However, a federal law passed in 2015 changed the landscape. As of January 1, 2020, Medigap plans that cover the Part B deductible are no longer available for sale to newly eligible Medicare beneficiaries. The government made this change to ensure beneficiaries have some “skin in the game,” theoretically reducing unnecessary doctor visits. The surprising part is that these plans did not disappear entirely. If you were eligible for Medicare before January 1, 2020, you still have the right to purchase Plan F or Plan C if you live in a state where they are sold. Furthermore, if you already had one of these plans before the cutoff date, you can keep it. This “grandfathering” rule allows long-term beneficiaries to retain coverage levels that are not available to those turning 65 today. MEDIGAP COVERAGE LASTS 365 DAYS LONGER THAN ORIGINAL MEDICARE Hospital stays can be incredibly expensive, and Original Medicare has limits on how many days it will cover. Under Part A, you are covered for the first 90 days of an inpatient hospital stay per benefit period. Once those 90 days are up, you have access to 60 “lifetime reserve days.” Once you use these reserve days, they are gone forever, and you are responsible for all costs. This is where Medigap provides a critical safety net. All standard Medigap plans offer an additional 365 lifetime reserve days of hospital coverage. This benefit kicks in after you have exhausted your Original Medicare hospital benefits. In the event of a catastrophic illness requiring a prolonged hospital stay, this feature alone could save you tens of thousands of dollars, providing peace of mind that your coverage will not run out when you need it most. YOU HAVE COVERAGE FOR EMERGENCIES OUTSIDE OF THE UNITED STATES A common misconception is that Medicare coverage travels with you wherever you go. While your coverage is nationwide, Original Medicare generally does not cover health care services received outside the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. For those who enjoy traveling abroad, specific Medigap plans offer a vital solution. Plans C, D, F, G, M, and N provide coverage for emergency care abroad. These plans typically cover 80 percent of the billed charges for medically necessary emergency care received outside the U.S., after you meet a $250 annual deductible. This benefit applies during the first 60 days of your trip and has a lifetime limit of $50,000. Having this protection means you can enjoy your international  adventures without the constant worry of what might happen if a medical emergency strikes far from home. NO ONE CAN EVER CANCEL YOUR MEDICARE SUPPLEMENT POLICY................. YOUR MEDIGAP PLAN IS GUARANTEED FOR LIFE! Insurance contracts can sometimes feel precarious, with the fear that a company might cancel your policy if your health declines or you file too many claims. With Medicare Supplement insurance, this is not a concern. Medigap policies are “guaranteed renewable.” This means that as long as you pay your premiums on time and were truthful on your application, the insurance company cannot cancel your policy. They cannot drop you because you developed a health condition, and they cannot cancel your coverage because you have used a high volume of medical services. This guarantee provides the security and stability essential to retirement planning. You can rest assured that your health insurance will remain in place for as long as you wish to keep it. WRAPPING THINGS UP YOU DO NOT HAVE TO NAVIGATE MEDICARE ON YOUR OWN Michael Braeden Is The Owner and Founder Of Braden Medicare Insurance. This Image Is A Copy Of Michael's Business Card. Navigating the complexities of Medicare can be daunting, but you do not have to do it alone. The right Medigap plan can protect your financial well-being and ensure you have access to the care you need, when you need it. If you are ready to see how much you could save or want to explore which standardized plan is best for your specific situation, we can help, and it doesn't cost you a penny. With over 10 years of helping Medicare Beneficiaries, we would be honored to help you as well. You can reach me via email at mike@bradenmedicare.com , or you can use the Contact page on our website @ www.bradenmedicare.com , or give us a call us at (480) 225-1393. We are a licensed, independent Medicare Broker and a Certified Medicare Insurance Planner. We are based in Arizona and are licensed in California, Colorado, Florida, Indiana, Iowa, Michigan, Nevada, New Mexico, Ohio, Oregon, Pennsylvania, Texas, and Wisconsin.

Michael T. Braden August 29, 2024 FINAL EXPENSE INSURANCE Final Expense Insurance Is Primarily Used To Cover Burial Expenses And Pay Off Debts, So Your Family Is Not Burdened By Them. FINAL EXPENSE INSURANCE FOR SENIORS   Burial Insurance has been around forever; however, in the last 20 years or so, the terminology and marketing of these types of policies have changed to FINAL EXPENSE INSURANCE. Initially designed to be enough insurance to cover the cost of one's own burial, so one's death would not become a financial hardship on surviving family members. But as with anything, life becomes more complex over time, as the world continues to grow and evolve.  Nowadays, Final Expense Insurance can cover Credit Card Debt, pay off Mortgages, Automobile Loans, and Student Loans, and cover Medical Bills, all in addition to "Funeral Expenses". Today, an average funeral costs between $7,000 and $12,000.  This includes viewing and burial, basic service fees, transporting remains to a funeral home, a casket, embalming, and other preparations.  The average cost of a funeral with cremation is $6,000 to $7,000.    FINAL EXPENSE INSURANCE FACTS No medical exams are necessary with Guaranteed Issue life or Final Expense life insurance policies.  Some companies may offer products at a slightly lower premium in exchange for the client agreeing to a physical exam . Once you purchase a Final Expense life insurance policy, the rates are level and fixed.  This means your monthly premiums will never increase. Final Expense policies are a type of whole-life policy that accrues Cash Value. Your benefits can never be reduced as long as your premiums are paid on time. Coverage is available for ages 0-89. Very affordable monthly payments. You can get coverage ranging from $2,500 - $50,000. If you are ever in the market for Final Expense Insurance , we can help you compare plans from our highly rated insurance companies.  Helping you research which companies have the highest ratings for financial strength and identify those that are established and have the resources to pay out on all claims promptly is just part of the service you get when you work with Braden MSI Insurance Services.

Michael T. Braden, September 7, 202 ANNUAL ENROLLMENT PERIOD THE MEDICARE ANNUAL ENROLLMENT PERIOD It is almost time again for the Annual Enrollment Period to begin. We are just five weeks away, so I thought it was time not just for a reminder, but to explain why this year's AEP (Annual Enrollment Period) may be one of the busiest in the last 10 years. One of your homework assignments before every AEP should be to review the Annual Notice of Change Letter you receive in September. Everyone with a Medicare Advantage Plan or a Medicare Part D Prescription Drug Plan will receive your ANOC (Annual Notice Of Change Letter). This letter is actually more like a packet or a dossier. And, it includes essential information about your current plan. Questions like: Will your plan still be available for the 2025 Plan Year? Have premiums gone up, or will your plan go away, leaving you to find a new plan for 2025? They will also include a side-by-side comparison of your plan in 2024 and your plan with any changes for 2025, so you can easily see if the plan still makes sense for you. Medicare And You Poster Stating The Annual Enrollment Period For Medicare Is Between October 15th and December 7th. WHAT YOU CAN DO DURING THE MEDICARE ANNUAL ENROLLMENT PERIOD THIS FALL The Fall Opera Enrollment Period runs from October 15th to December 7th. Here is what you can do during this critical time: If you are a Medicare Advantage Member, you can choose to stay with your current Medicare Advantage Plan, as long as your plan is still available. If that is what you decide to do, then you do not need to do anything else. Your plan will automatically renew on January 1st. If you have a Medicare Part D Prescription Drug Plan, you really need to investigate your options for 2025. Why? Well, because there are some significant changes to ALL Part D Plans in 2025, thanks to the Biden Administration's Inflation Reduction Act (IRA), which obviously has done nothing to curb inflation. LET'S LOOK AT THE CHANGES BROUGHT ABOUT BY THE IRA: For starters, the maximum out-of-pocket amount for Prescription Drugs in 2025 will be $2,000. The Catastrophic Phase of Coverage, which everyone referred to as the Donut Hole, is gone in 2025. Medicare Part D Premiums are increasing by 6% overall. The Medicare Part D Plan Deductibles are increasing to $595.00. You will have the option to defer payment of your initial prescriptions. You can make payments at the pharmacy without paying the full amount . This is intended as a helping hand ; it is not a loan. Your prescriptions are not free, and you must make your installment payments or risk losing your coverage. Many Part D Plans have been dropped for the coming year. In Arizona alone, Mutual of Omaha and BCBS will no longer offer Part D Drug Plans. Other companies have cut back on the variety of plans they offer . YOUR MAILBOX WILL BE FILLED WITH AN ENORMOUS AMOUNT OF JUNK MAIL. MOST OF THIS IS 99% JUNK MAIL We have always recommended that the only mail you should keep during the AEP is: Anything from CMS (Centers for Medicare & Medicaid Services). Anything from Social Security. Anything from your current Insurance Provider, including your Medicare Advantage Plan, Prescription Drug Plan, and Medicare Supplement Plan. Everything else is just junk (flyers, brochures , and propaganda from other insurance companies and agents ). YOUR EYES AND EARS WILL BE BOMBARDED WITH MEDICARE TELEVISION ADS AND RADIO ADS These Medicare Insurance Companies (Mostly Medicare Advantage Plans) use funds from the Government to pay for these ads. They are slick ; they are intentionally written and produced to confuse the viewer, imploring them to call a Toll-Free Number so that you can "make sure you are getting all of the benefits you are entitled to". Pardon me, but these vultures are simply preying on the fears and confusion of Seniors. However, they do not tell the whole story. Most people who call those numbers end up enrolling in a Medicare Plan from another company, usually one with fewer benefits and higher copays than your current Medicare Advantage (Medicare Part C) plan . They do not realize their new strategy is suboptimal until they see a doctor in March or April, and they are stuck with that plan for the rest of the year. Remember this about Medicare Advantage plans. Not every plan and not all benefits are available in every market. There are more than 4,400 Medicare Advantage plans nationwide. They may quote a benefit you have not heard of before, usually because it is not available where you live. NOTE: If you have a friend, relative , or loved one with Medicare, please assist them in finding an experienced Independent Medicare Broker in their area. By doing this, they will always have someone to call whenever they have a question. Someone who does not charge a penny for their services, an expert in Medicare and Medicare Insurance plans, and someone who understands all available options . WHY ARE PEOPLE MOTIVATED TO CHANGE THEIR MEDICARE PLANS OR MEDICARE COVERAGES THE MEDICARE ANNUAL ENROLLMENT PERIOD, AND THE FALL ENROLLMENT PERIOD ARE THE SAME THING Also known as the Annual Election Period, the Medicare Fall OEP was introduced with the launch of Medicare Part D in 2006. It is an 8-week period every fall during which Medicare beneficiaries can enroll in, change, or disenroll from their Medicare Advantage and/or Part D drug plans. Here’s why the period exists: Part D and Medicare Advantage plans can refile their benefits with Medicare each year. This means the benefits and premiums under your plan may change or increase. Medicare offers an annual election period to change your plan if you don’t like changes to your existing coverage. Basically, your Medicare Prescription Drug benefits change every year, so you get an election period to change your plan if you don’t like those benefit changes. The good news is that you do not have to change your plan if you like it . In fact, statistics show that most beneficiaries do not make changes to their plans each year. However, you should review the upcoming plan changes every September. WHAT CAN YOU DO OR CHANGE DURING THE AEP? Your choices for plan changes during the Medicare OEP? Do nothing, and your current Medicare coverage will automatically renew in 2025 Enroll in, leave, or change your Medicare Part D drug plan. Switch from Traditional Medicare to a Medicare Advantage plan. Switch from a Medicare Advantage plan back to Traditional Medicare. Change from one Medicare Advantage Plan to another Please remember that Medicare Part D drug plans do not include health questions. You can change to any other plan as long as you have either Medicare A and/or B, and you live in the plan’s service area. Medicare Advantage plans have only one health question about End Stage Renal Disease, so it’s also relatively easy to enroll in or change your Medicare Advantage plan as long as you don’t suffer from this particular health condition. HERE ARE THE BEST AND MOST COMMON REASONS WHY PEOPLE CHANGE THEIR MEDICARE ADVANTAGE OR THEIR PRESCRIPTION DRUG PLANS EACH YEAR Your plan is dropping one of your essential medications next year. Your Annual Notice of Change letter will specifically list any changes to its drug formulary for next year. The plan must disclose if they are dropping any medications. They must also inform you if a medication is moving to a higher-tier price for next year. If you take a brand-name medication now that won’t be covered the following year, you may want to change during the OEP to another drug plan that will. Your Medicare Advantage plan is dropping your doctor from its network. Unlike Medigap plans, Medicare Advantage plans have a network of doctors. If one of your doctors is leaving the plan’s network, you can use the Medicare OEP to switch to another plan that your doctor still participates in. Your plan has a significant premium increase. Please note that the keyword here is “drastic.” Inflation affects medical insurance plans just as it does auto insurance plans. If your auto insurance increases by $3/ 3/month next year, would you go to the trouble of changing it? Probably not. Likewise, if the only change to your drug plan is a slight premium increase , you don’t have to switch. But if your drug plan goes up $20/month, you might look to see if any other plan is cost-effective. MEDICARE CHANGES FOR THE 2025 PLAN YEAR In 2018, the Bipartisan Budget Act brought about changes to Medicare Advantage plans. While Original Medicare does not cover supplemental home health benefits, Medicare Advantage plans can now include them. If you are looking at Medicare Advantage plans, you may notice that many now include supplemental home health benefits. This may include personal support services in your home, transportation to and from medical appointments, adult day care , telehealth medical appointments, over-the-counter allowances, and meal delivery. WHAT ABOUT YOUR MEDIGAP OR MEDICARE SUPPLEMENT PLAN? YOUR MEDICARE SUPPLEMENT OR MEDIGAP PLAN Your Medigap plan has federally standardized benefits that do not  change from year to year, unlike Part D plans. If you have a Medigap Plan F, Plan G , or Plan N (or any other Medigap plan), rest assured that nothing will change with the benefits. Your plan next year will continue to cover the same benefits as this year. Rates May Change, Benefits Do Not Medigap plans typically have annual rate increases, which take effect on your policy anniversary date. If you bought your policy on January 1 of a past year, your policy renewal occurs each year on January 1. That means you will receive your notice of increase from your carrier in December. It occurs alongside the OEP but is unrelated to the Medicare Fall Open Enrollment Period. Think of this like your automobile, renters, or homeowners insurance: If you originally purchased your homeowners' insurance on June 1st, 2014, you will receive a rate increase every year on June 1st . The same applies to Medicare supplement insurance. If your Medigap plan renews each year in January because you originally bought it with a January 1st effective date, that is coincidental. The plan’s benefits are not changing; only the premium varies from year to year for Medigap plans. SHOULD YOU SHOP YOUR MEDICARE SUPPLEMENT PLAN DURING THE AEP? Now that you know your Medigap benefits will not change, it’s up to you whether you want to shop for it in the fall. Some people shop for it because they are already comparing Part D plans so that they can knock out both items on their to-do list for that year. We often find people who have been on the same Medigap plan for years and are hesitant to change because the plan pays so well. Rest assured, Medigap plans are standardized. Anyone with a Medicare Supplement/Medigap plan should review rates at least every other year to ensure they are not leaving money on the table. The Medicare OEP Does Not Prevent Underwriting on New Medigap Policies Many people mistakenly believe that you can change your Medigap plan during the OEP without health questions. That is not the case because, as noted above, the OEP doesn’t apply to Medigap. In most states, you will need to answer health questions in the new application. The insurance company can decide whether to accept or reject you. Medigap plans require you to pass medical underwriting unless you have an exceptional circumstance that qualifies you for a guaranteed issue window. For example, if you move out of state mid-year, you’ll be given a Special Election Period. You can use this short window to switch to a plan available in your new service area. If you don’t have a special election period, you’ll need to answer health questions to get approved for a new Medigap plan. IS THE MONTHLY MEDICARE PART B PREMIUM GOING UP IN 2025? Every year, the federal government can adjust your Medicare Part B premium. Part B premiums are tied to the Cost of Living Adjustment in your Social Security benefits. In 1965, new enrollees paid $3 per month for Medicare Part B.  In 2024, new enrollees pay at least $174.70/month, but this will likely change for 2025. Some people pay more based on their household gross income. Generally, Social Security issues a COLA inflation adjustment that increases your Social Security monthly income benefits, and then the Part B premium usually also goes up. The most common projection I have seen is that Social Security Benefits are likely to increase by around 2.6% in 2025. I expect a modest increase in Part B Monthly Premiums. Usually, we do not know the new Premiums for Part A and Part B until October. WRAPPING THINGS UP I hope this article about the Medicare Annual Enrollment Period was helpful, informative, and engaging . We would love to hear your comments, so please feel free to email us at mike@bradenmedicare.com anytime, and please ask to sign up for our monthly newsletter.

Understanding Medicare and its enrollment options can be overwhelming. Each year, millions of people review and adjust their Medicare plans during the Medicare Annual Enrollment Period. This period is crucial for ensuring you have the right coverage to meet your health needs and budget. This guide will help you navigate the process with confidence and clarity. Braden Medicare Insurance's AEP Prep Poster stating Preparing For Medicare's Annual Enrollment Period (AEP) Understanding the Medicare Enrollment Period The Medicare enrollment period is a designated time each year when beneficiaries can make changes to their Medicare coverage. This period typically runs from October 15 to December 7 annually. During this time, you can: Switch from Original Medicare to a Medicare Advantage plan. Change from one Medicare Advantage plan to another. Enroll in a Medicare Part D prescription drug plan. Drop your Medicare prescription drug coverage. Making changes during this period ensures your coverage will be adequate starting January 1 of the following year. It is essential to review your current plan carefully and consider any changes in your health needs or budget before making decisions. Braden Medicare Insurance's Medicare Enrollment Periods Poster How to Prepare for the Medicare Enrollment Period Preparation is key to making the most of the Medicare enrollment period. Here are some practical steps to help you get ready: Review Your Current Coverage Look at your current Medicare plan details, including premiums, deductibles, copayments, and coverage limits. Consider whether your plan still meets your health needs. Assess Your Health Needs Think about any changes in your health or medications over the past year. Are there new prescriptions or treatments you need covered? Compare Plans Use online tools or consult with a Medicare expert to compare available plans in your area. Pay attention to costs, coverage options, and provider networks. Gather Important Documents Have your Medicare card, current plan information, and a list of medications handy. This will make the enrollment process smoother. Mark Your Calendar Don’t miss the enrollment window. Set reminders to review and submit your plan changes before the deadline. Taking these steps will help you make informed decisions and avoid costly mistakes. What is the difference between Medicare OEP and AEP? Two critical enrollment periods often confuse: the Open Enrollment Period (OEP) and the Annual Enrollment Period (AEP). Understanding the difference can help you determine when and how to adjust your Medicare coverage. Annual Enrollment Period (AEP) This is the main enrollment window from October 15 to December 7. During AEP, you can make a wide range of changes to your Medicare plans, including switching between Original Medicare and Medicare Advantage, changing Medicare Advantage plans, or enrolling in or dropping Part D prescription drug coverage. Open Enrollment Period (OEP) The OEP runs from January 1 to March 31 each year. It is more limited in scope. During OEP, if you are already enrolled in a Medicare Advantage plan, you can switch to a different Medicare Advantage plan or return to Original Medicare. However, you cannot join a Medicare Advantage plan if you are not already enrolled in one, nor can you add or drop Part D coverage during this time. Knowing these differences helps you plan your coverage changes effectively and avoid missing important deadlines. Tips for Choosing the Right Medicare Plan Choosing the right Medicare plan can be challenging, but focusing on your personal needs will guide you to the best choice. Here are some tips: Consider Your Health Care Providers Check if your preferred doctors and hospitals are included in the plan’s network. Evaluate Prescription Drug Coverage Ensure the plan covers your medications and review the associated costs. Look at Total Costs Don’t just focus on monthly premiums. Consider deductibles, copayments, and coinsurance. Check Extra Benefits Some Medicare Advantage plans offer additional benefits such as dental, vision, and hearing coverage. Use Available Resources Utilize Medicare’s official tools or consult with licensed agents who can provide personalized advice. By carefully weighing these factors, you can select a plan that fits your health needs and financial situation. How to Enroll or Make Changes During the Medicare Annual Enrollment Period When you are ready to enroll or make changes, follow these steps: Visit the Official Medicare Website or Contact a Licensed Agent You can enroll online, by phone, or with the help of a Medicare counselor. Review Your Choices Double-check the plan details, costs, and coverage before submitting your application. Submit Your Enrollment or Change Request Make sure to complete the process before the December 7 deadline. Keep Confirmation Records Save any confirmation numbers or emails you receive for your records. Monitor Your Mail You will receive a new Medicare card or plan documents before your coverage starts on January 1. If you need assistance, many organizations offer free counseling to help you understand your options. Staying Informed Beyond the Enrollment Period Medicare coverage and rules can change each year. Staying informed helps you avoid surprises and ensures you always have the best coverage for your needs. Read Annual Notices Every fall, your plan will send an Annual Notice of Change (ANOC) explaining any changes for the following year. Review Your Coverage Annually Even if you don’t plan to change your plan, review your coverage each year during the enrollment period. Ask Questions Don’t hesitate to contact Medicare or a trusted advisor if you have questions about your coverage. Keep Track of Deadlines Mark important dates on your calendar to avoid missing enrollment opportunities. By staying proactive, you can maintain peace of mind about your healthcare coverage. Person researching Medicare plans online. For more detailed information and personalized assistance, visit the Medicare Annual Enrollment Period page to explore your options and get expert guidance.

Michael T. Braden, March 1, 2023 MEDICARE & TAXES DID YOU KNOW THAT ONE OF THE BEST BENEFITS WE GET AT AGE 65 IS WHAT MEDICARE EXPENSES WE CAN DEDUCT FROM OUR TAXES MEDICARE & YOUR TAXES Believe it or not, this article should make everyone feel good. It is one of the perks we receive for reaching the milestone of 65 years of Life. This is an important question to answer during tax season. Each year, U.S. citizens may deduct personal expenses from their taxable income. Deductions reduce taxable income, lowering one’s tax burden. From this article, you’ll learn about what Medicare costs you can deduct from your taxes. We will talk in-depth about Medicare expenses that are and are not deductible, about whether and when the self-employed can deduct their health insurance premiums, and whether or not you can pay for your Medicare premiums with your HSA funds. YOU HAVE TO CHOOSE TO ITEMIZE YOUR DEDUCTIONS TO DEDUCT YOUR MEDICARE PREMIUMS An individual can deduct Medicare premiums, including Medicare supplement premiums, as a medical expense on their tax return. That means only to the extent that total medical expenses exceed 7.50% of your Adjusted Gross Income.  Self-employed individuals can deduct Medicare premiums on Schedule A of the 1040 as an “above-the-line” deduction.  You can use HSA funds to reimburse yourself for Part B premiums, but not for Medicare supplement premiums.  While this article is intended for general informational use, please consult a tax professional for detailed guidance. It’s best to use a professional to stay off the Internal Revenue Service radar. ARE YOUR MEDICARE PREMIUMS TAX DEDUCTIBLE? Are we often asked whether Medicare premiums are tax-deductible? Generally speaking, your Medicare premiums are tax-deductible; however, certain limitations apply.  The main rule states that Medicare beneficiaries may deduct their Medicare health insurance premiums from their federal taxes, provided their total medical and dental expenses exceed 7.5% of their adjusted gross income. This is referred to as the medical expense deductions.  If that is the case for you, you can deduct the premiums, a key point, which will reduce your adjusted gross income. Your taxes will be calculated based on your taxable income minus the deduction.  The important note here is that this threshold applies to your federal income tax return. States may have different rules for calculating medical expense deductibles. Please check your state rules.  How are Medicare premiums tax-deductible? To properly deduct medical expenses on the federal income tax return, you will need to file Schedule A of Form 1040, Itemized Deductions .   We’ve established that Medigap premiums are deductible. How do you deduct them?  Very easy to do – you include them on Schedule A, Itemized Deductions for Form 1040, as itemized medical expenses. Again, you must be itemizing deductions to get a benefit from this deduction. In an example, let’s say your AGI is $30,000. From that number, 7.5% is $2,250. If your itemized deductions are $4,000, then you have deductible expenses of $1,750. Using these numbers, if your medical expenses did not exceed $2,250, you would not be able to itemize and deduct medical expenses. ARE MEDIGAP PLAN PREMIUMS CONSIDERED TO BE TAX DEDUCTIBLE? It’s also crucial to emphasize that Medicare premiums are tax-deductible for a few Medicare plans. Medicare Part A (if you pay a premium), Part B , and Part D, as well as Medicare Advantage Plan and Medicare Supplement premiums, can all be used as itemized deductions. Part A premiums are tax-deductible from your tax return as long as you meet specific criteria. Most Part A insurance beneficiaries don’t pay any premiums for this coverage; this won’t apply to them. Deducting Medicare-related premiums for Medicare Part A is possible for those who pay premiums for this plan and, at the same time, do not collect Social Security benefits. WHAT ARE ITEMIZED DEDUCTIONS? Itemized deductions are expenses that can be subtracted from your adjusted gross income (AGI). As noted above, insurance premiums and medical costs can be itemized deductions. STANDARD DEDUCTIONS MAY BE HIGHER THAN ITEMIZED DEDUCTIONS IN SOME CASES When filling out your tax return, you will have the option to choose a  Standard Deduction or  an Itemized Deduction . A standard deduction is a specific dollar amount that reduces the amount of income on which you’re taxed without itemization. The standard deduction for 2022 is $12,950 for a single filer or married filing separately. The standard deduction for head of household is $19,400 , and for married filing jointly, it is $25,900 . For many years, the standard deduction has significantly reduced your taxes compared with itemizing. Itemized Deductions, in contrast, allow you to add up all your qualified itemized deductions and then claim that amount. They can include expenses such as medical costs, mortgage interest, personal property taxes, and disaster losses. To deduct medical expenses from your taxes, you need to choose the Itemized Deductions. Of course, this route will make sense ONLY if your itemized deductions exceed the standard deduction. If that is not the case, it will be more profitable for you to claim a standard deduction. WHAT MEDICARE EXPENSES ARE TAX DEDUCTIBLE ACCORDING TO THE IRS? Okay, so we’ve covered the fact that Medicare premiums are tax-deductible, but what about the other medical expenses that may not be included in your health insurance plan? Are medical costs that are paid out of pocket tax-deductible as well? Again, the answer is yes, but as with Medicare premiums, there are thresholds for some of these expenses, particularly long-term medical care. HERE IS A LIST OF SOME OF THE ITEMS THE IRS DETERMINES TO BE TAX-DEDUCTIBLE MEDICAL DEDUCTIONS  Hearing Aids/Hearing Aid Batteries  Bandages, Band-Aids, Compression Sleeves, Braces  Vision Care (Eye Exam Cost and Cost of Eyeglasses and Contact Lenses)  Home Remodeling costs necessary to meet Medical/Healthcare Requirements  All Costs to train and acquire Service Animals  Psychological and/or Psychiatric Care  Critical Care, Long-term Care Insurance Premiums  Hospital Indemnity Insurance Premiums  Nursing home expenses for those whose primary cause of stay was medical care;  Medical Transportation Expenses  Personal Protective Equipment  Any/All DME  Dentures  Wig(s) If Recommended By a Medical Professional WHO IS ELIGIBLE TO QUALIFY FOR A LONG-TERM CARE POLICY TAX DEDUCTION PREMIUM? FOR THE 2022 TAX YEAR, THESE PREMIUMS ARE TAX DEDUCTIBLE FOR EACH OF THE FOLLOWING:  Anyone 40 or younger with a deductible of $450.  Anyone 41 to 50, with a deductible limit of $850.  Anyone 51 to 60, with a deductible limit of $1,690.  Anyone 61 to 70, with deductible limits of $4,510.  Those over 71 with a Deductible Limit of $5,640. WHAT EXPENSES WOULD NOT BE CONSIDERED TO BE TAX DEDUCTIBLE? Unfortunately, not every expense is tax-deductible under IRS rules. INCLUDED IN THIS LIST:  Cosmetic Procedures and/or Improvements (unless they regard deformations caused by accident);  Non-Prescription Medications  Fitness Club Memberships  Any Services Paid from using HSA funds ARE ALL MEDICARE CO-PAYS & CO-INSURANCE TAX DEDUCTIBLE? Yes, you may deduct co-payments and co-insurance amounts from your taxes; you need to itemize your deductions to make sure your Co-Payments are fixed payments made by the insured for various medical services. Often, patients are obligated to pay co-pays for services after they’ve reached their insurance deductibles for said services for that year. Is it possible to deduct these expenses when you pay taxes? Essentially, co-pays are viewed as a qualified medical expense you pay out of your pocket, so the answer is yes , you can deduct them on your tax return. The same rules apply here as mentioned earlier : your Medicare premiums are tax-deductible, and your healthcare costs can be deducted from your income taxes. However, tax deductions for Medicare costs and deducting Medicare premiums require that you itemize your deductions from your income taxes. Only if your itemized deductions exceed the standard deduction will this effort help you save money. You are encouraged to consult a tax professional when itemizing deductions. ARE MEDICARE PREMIUMS FOR SELF-EMPLOYED INDIVIDUALS TAX DEDUCTIBLE? Freelancers and self-employed professionals can also benefit from deducting Medicare premiums, but there are significant differences compared with individuals . Primarily, self-employed individuals have the option to apply this tax deduction without meeting the 7.5% adjusted gross income threshold. They are also not obligated to itemize their deductible medical expenses. However, there are some criteria they need to meet. To benefit from this solution:  You are obligated to report a net profit from your business.  You and your spouse cannot be eligible for an employer’s health coverage other than your own  The tax-deductible premiums from Medicare cannot amount to more than the profits you earned from your operation. As a self-employed individual, you can deduct your Medicare premiums to a similar degree as those who are retired. You can deduct premiums from Original Medicare, as well as Part D, Medicare Advantage plans, and Medigap plans. The same goes for long-term health care expenses. ARE MEDICARE PREMIUMS BASED ON TAXABLE INCOME? For the self-employed, your health insurance premiums are 100% tax-deductible . Tax-deductible premiums can reduce your adjusted gross income AGI. This includes monthly premiums for Original Medicare, as well as other insurance plans such as Medigap, Part D prescription drug plans, and more . CAN I DEDUCT MY MEDICARE PREMIUMS IF I DO NOT ITEMIZE MY DEDUCTIONS? Yes, but only if you meet the requirements for self-employment. You might be allowed to deduct your premiums without itemizing them. In other cases, itemized deductions are required to claim tax reduction based on your Medicare and other Health Care Expenses. I am not a CPA, but several accounting professionals have advised that it is best to itemize to avoid tax-related issues. CAN I USE MY HSA ACCOUNT TO PAY MY MEDICARE PREMIUMS? Technically, with an HSA, you are reimbursing yourself for certain health-related expenses. Yes, you can use an HSA account to reimburse yourself for your Medicare premiums. Funds accumulated in a health savings account can be used to cover premiums, insurance deductibles, and copayments, as well as the costs of most tax-deductible medical procedures and services . While withdrawing these funds before or after enrolling in Medicare is possible, " you cannot use your tax-free HSA savings to pay for your medical expenses and benefit from a tax deduction on the same expenses". This means that you have to decide whether you want to, for example, pay for your out-of-pocket medical costs using HSA funds or deduct those expenses later on your federal tax return. If you’re 65 or older, you can use your HSA savings to pay for Medicare Part A, Part B, Part D, and Medicare Advantage. However, you may not use these funds to pay for your Medicare Supplement premiums. Money accumulated in your HSA account is tax-free if you’re withdrawing it at the age of 65 or older. IS MEDICARE A TAX DEDUCTION? Yes, you can deduct your Medicare premiums and other medical expenses on your federal tax return. Certain conditions must be met to qualify for this deduction. To deduct Medicare expenses, they need to amount to more than 7.5% of your Adjusted Gross Income. Those who are not self-employed must itemize these deductions to benefit from this tax benefit. DO MY MEDICARE PREMIUMS REDUCE MY TOTAL TAXABLE INCOME? Since you may have the option to deduct medical expenses, including Medicare premiums, from your taxable income, Medicare premiums can reduce your taxable income. CAN RETIREES DEDUCT THEIR MEDICARE PREMIUMS? Yes, if you’re retired, you can deduct your Medicare premiums. If you or your spouse is still working and eligible for employer-subsidized healthcare, you may not qualify for Medicare premiums tax deductions. ARE THE MEDICARE PREMIUMS I HAVE TAKEN DIRECTLY OUT OF MY SOCIAL SECURITY PAYMENTS TAXABLE? Yes. If you’re signed up for Medicare Part B and Social Security, the Social Security Administration will automatically deduct the insurance premium from your monthly benefit. Medicare Part A is free for those who receive Social Security benefits. If you have Medicare Part C and Part D, you can deduct those premiums as well. HOW MUCH WILL THE MEDICARE PART B DEDUCTIBLE BE NEXT YEAR? The Medicare Part B deductible for 2023 is $226. Medicare beneficiaries pay a standard monthly premium of $164.90 for this coverage. They will announce the Part B Deductibles for the upcoming year in September or October. We estimate that they will increase the Part B Deductible because they raised the Social Security COLA in 2022 and 2023. I would plan for approximately $233.00 for 2024. IS IT NECESSARY TO SHOW PROOF OF HEALTH INSURANCE AFTER AGE 65? No, the IRS does not require taxpayers to provide proof of health insurance. However, it is recommended to keep those records. This documentation may include statements from your insurance company, Form 1095 information forms, insurance cards, or W-2 or payroll statements reflecting health insurance deductions. More information on the subject is available at this link. Always keep a record of premiums paid. REMEMBER................ Those who want to save money when filing their tax return will be glad to know that Medicare premiums, as well as many other medical expenses, are tax-deductible . There are specific requirements that must be met to deduct premiums from taxable income. Deducting medical expenses is possible once these costs make up more than 7.5% of your Adjusted Gross Income. Self-employed individuals can deduct premiums and other medical expenses without meeting this requirement, but their income cannot exceed the deductible . If you are over 65, you can use your HSA tax-free savings to pay premiums and cover the costs of medical services, but you are not allowed to deduct reimbursed expenses on your tax return. Hopefully, this guide sheds light on medical expense deductibles, giving you a better understanding of who and when can benefit from this tax break.

Michael T. Braden, September 10, 2024, Medicare Supplement Plans WHAT IS A HIGH DEDUCTIBLE MEDICARE SUPPLEMENT PLAN? IS A HIGH DEDUCTIBLE MEDICARE SUPPLEMENT PLAN G WORTH CONSIDERING? For many people, High Deductible Medigap Plans (HDG and HDF) may make sense, but they would not be my first choice for most Medicare Beneficiaries. The appeal of a High-Deductible Medicare Supplement/Medigap plan is its lower premiums, some of which can be under $50 per month. But, instead of having the regular $240.00 Part B Deductible, the Deductible is $2,800. But that in itself is misleading. Original Medicare will still pay 80% of all costs from day one, and you will still have to pay the Part B Deductible of $240.00. But that does count toward the $2,800 Deductible for the Plan. Your maximum out-of-pocket expense is $2,800 for the year. Conversely , if you chose the traditional Medicare Supplement route, a Plan G will cost around $150 per month until Age 70; some may be higher based on your Tobacco use, and a Plan N would run in the neighborhood of $100 per month . For Plan G , the premium is $1,800 per year, and your only Out-Of-Pocket Costs should be $240 —the Part B deductible—totaling $2,040. A Plan N would cost approximately $1,440, including the Part B Deductible. My concern for everyone is to A) keep as much money in your pocket as possible. B) Be aware that the rate is much lower for an HDG, but what happens if you get dealt a bad hand? If you have a Cancer Diagnosis, Cardiac Issues, COPD, Diabetes, etc you may not be able to pass Underwriting to switch to a regular Plan G or Plan N in the future. Most years , you will likely save money with a High-Deductible plan G, but is it worth the risk? I think if you are financially secure and have done a great job of preparing for retirement, this may work well, but for the masses, I think a Medicare Supplement Plan G or Plan N is a better fit. What Is A High Deductible Medicare Supplement IMPORTANT FACTS ABOUT HDG IN 2024 The High Deductible Plan G has a $2,800 deductible in 2024. Once the deductible is met, the High Deductible Plan G covers 100% of the cost of approved services. The Part B annual deductible is included in the High Deductible plan. Isn't THERE ALSO A HIGH DEDUCTIBLE PLAN F? For beneficiaries who became eligible for Medicare on or after January 1, 2020, a High Deductible Plan G option will be available. This plan will be like the High Deductible Plan F; however, it will not cover your Part B deductible. Since Plan F has historically been more expensive than Plan G, I cannot say that a High Deductible Plan F is a better option than a High Deductible Plan G. REMIND ME AGAIN ABOUT HOW A HIGH DEDUCTIBLE PLAN G (HDG) WORKS With a High Deductible Medicare Supplement Plan G, the best place to begin understanding coverage is with the original plan. Therefore, in this scenario, Medicare Supplement Plan G is the parent plan. To sum it up, Plan G covers your whole portion of medical benefits that are left over after Original Medicare has paid its portion, except for the Part B deductible. Likewise, a High Deductible Plan G provides coverage in the same way, but only after you meet your annual deductible. 2024 MEDICARE SUPPLEMENT PLAN COMPARISON CHART 2024 Medicare Supplement Plan Comparison Chart IS THE PART B DEDUCTIBLE INCLUDED IN THE HDG? The Part B deductible is included within the High Deductible plan’s deductible. Therefore, the enrollee would pay the first $240, Medicare would pay 80% of Part B services, and the enrollee would pay the remaining 20% until the deductible is satisfied. However, there is one rare situation. If an enrollee meets the $2,800 deductible with only Part A services, they would still pay the $240 in full, in addition to the $2,800 deductible. Medicare Part B would not pay its 80% cost-sharing until the $240 is satisfied. That is why you must know how Medicare works and how much Medicare costs when you are considering enrollment in a High Deductible Plan G, since you are responsible for the remaining balance until the high deductible is met. WHAT HAPPENED TO MEDIGAP PLAN F? When the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was enacted, it made significant changes to Medigap plans as we know them. This legislation was designed to prohibit any Medigap plan from covering the Medicare Part B deductible (so the playing field was level for everyone), also referred to as first-dollar coverage. The key point is that for those newly eligible for Medicare on or after January 1, 2020, Plans C and F (including the high-deductible option) are no longer available unless you were 65 before January 1, 2020. IF YOU SWITCH CARRIERS IN THE MIDDLE OF THE YEAR, WILL ANY MONEY YOU HAVE PAID IN COUNT TOWARDS THE DEDUCTIBLE? No. The deductible will reset when you switch to another carrier with the same High Deductible plan. IS THERE ANY ADVICE WE WOULD OFFER TO SOMEONE CONSIDERING ANY HIGH DEDUCTIBLE MEDICARE SUPPLEMENT PLAN? Yes, if you have sufficient funds set aside for Medical expenses, either from your bank account or from a large balance in your HSA, an HDG could be viable. WHAT ARE PEOPLE SAYING WHO HAVE GONE THIS ROUTE? I will say that the feedback we receive from clients who go this route is that the lower premiums are often not worth the trouble. If you’re unsure which Plan G policy to go with, you can read reviews on Medicare Plan G to help. My best advice before enrolling in this plan is to do your homework and fully understand what you’re signing up for before you make your decision.